摘要
目的探讨不同剂量甲泼尼龙治疗儿童难治性肺炎支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)的临床效果。方法以河南科技大学附属医院2019年1月至2022年1月收治的RMPP患儿153例为研究对象,依据甲泼尼龙不同治疗剂量分为大剂量组(n=51,每次10 mg·kg^(-1)·d^(-1))、中剂量组(n=51,每次5 mg·kg^(-1)·d^(-1))与小剂量组(n=51,每次2 mg·kg^(-1)·d^(-1))。比较三组疗效、症状消失时间、炎性因子水平及不良反应发生率。结果大剂量组疗效总有效率(98.04%)高于中剂量组(90.20%)与小剂量组(74.51%),差异具有统计学意义(P<0.05)。治疗后大剂量组发热、咳嗽、肺部湿啰音等症状消失时间均比中剂量组与小剂量组短,中剂量组比小剂量组短,差异均有统计学意义(P<0.05)。三组治疗后C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)及肿瘤坏死因子-ɑ(tumor necrosis factor-α,TNF-α)水平均降低,且三组治疗后CRP、IL-6、TNF-α水平降低程度比较,差异均有统计学意义(P<0.05),大、中剂量组CRP下降程度比较,差异无统计学意义(P>0.05),中、小剂量组IL-6、TNF-α下降程度比较,差异无统计学意义(P>0.05)。大剂量组不良反应总发生率7.84%,中剂量组11.76%,小剂量组9.80%,差异无统计学意义(P>0.05)。结论不同剂量甲泼尼龙治疗儿童难治性肺炎支原体肺炎,大剂量甲泼尼龙与小剂量和中剂量甲泼尼相比疗效更显著,更能有效缩短症状消失时间,减轻炎性反应,安全性较好。
Objective To probe the clinical efficacy of different doses of methylprednisolone in the treatment of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods One hundred and fifty-three children with RMPP in our hospital from January 2019 to January 2022 were enrolled,and classified into three groups according to different doses of methylprednisolone,high dose group(10 mg·kg^(-1)·d^(-1);n=51),medium dose group(5 mg·kg^(-1)·d^(-1);n=51)and low dose group(2 mg·kg^(-1)·d^(-1);n=51).Then the clinical efficacy,time to disappearance of symptoms,levels of inflammatory factors and incidence of adverse effects were compared among the three groups.Results The clinical efficacy rate was 98.04%in high dose group,which was higher than 90.20%in medium dose group and 74.51%in low dose group,with statistical difference(P>0.05).The disappearance time of fever,cough and lung wet rales among three groups was the shortest in high dose group,followed by medium dose group and low dose group,with statistical difference(P<0.05).A reduction was detected in serum levels of C-reactive protein(CRP),interleukin 6(IL6),and tumor necrosis factor-α(TNF-α)in all three groups,and the decline in three groups had statistical difference(P<0.05).The decline in CRP of high dose group yielded no statistical difference with that of medium dose group(P>0.05),and no statistical difference was found in the decline in serum IL-6 and TNF-αlevels between medium and low dose groups(P>0.05).The total adverse reaction rate was 7.84%in high dose group,11.76%in medium dose group and 9.80%in low dose group,with no statistical difference(P>0.05).Conclusion Compared to low and medium dose of methylprednisolone,high doses of methylprednisolone was more effective and safe in the treatment of RMPP in children in terms of the shorter relief time and obvious attenuation of inflammatory response.
作者
李富
雷国峰
赵宇欣
马惠
张永强
LI Fu;LEI Guofeng;ZHAO Yuxin;MA Hui;ZHANG Yongqiang(Department of Paediatrics,the First Affiliated Hospital of Henan University of Science and Technology,Sanmenxia 472000,China;Department of Radiology,Sanmenxia Central Hospital,Sanmenxia 472000,China)
出处
《西南医科大学学报》
2023年第6期513-516,529,共5页
Journal of Southwest Medical University
基金
河南省医学科技攻关计划联合共建项目(LHGJ20191439)。
关键词
甲泼尼龙
儿童难治性肺炎支原体肺炎
不同剂量
临床疗效
Methylprednisolone
Refractory Mycoplasma pneumoniae pneumonia in children
Dosage
Clinical efficacy
